Blood test, PSA (prostate screen)
Facility: Wesley Medical Center
Billing Code: 84153 (CPT)
- CPT Billing Code: 84153
- Insurance Median: $40
- Cash Discount Price: $815
- vs. Medicare Baseline: 2.18x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $18.39 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 218% of the Medicare baseline (a markup of 118%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $18 | 98% |
| Humana | $18 | 98% |
| Coventry Health Care | $18 | 98% |
| Aetna | $18 - $291 | 98% |
| United | $18 - $367 | 98% |
| Devoted Health | $18 | 98% |
| Ambetter / Centene | $19 - $147 | 103% |
| Amerigroup | $19 | 103% |
| Triwest Health Alliance | $19 | 103% |
| Medicaid / KanCare | $19 | 103% |
| Correct Care Solutions | $28 | 152% |
| First Health | $39 - $376 | 212% |
| Multiplan | $40 - $734 | 218% |
| Blue Cross Blue Shield | $50 | 272% |
| Health Partners Of Kansas | $141 - $408 | 767% |
| Wppa | $142 | 772% |
| Preferred Health Choices | $154 | 837% |
| Medical Associates Health Plan | $154 | 837% |
| Spirit Aerosystems | $261 | 1419% |
| Triwest Healthcare Alliance | $530 | 2882% |
| Usa Managed Care | $693 | 3768% |
Consumer Guidance & Cost Commentary
For the blood test, PSA (prostate screen) procedure at Wesley Medical Center in Wichita, KS, the cash price is $815.00, which matches the facility's median paid amount. This cash rate is significantly higher than the Medicare benchmark of $18.39, reflecting a markup of 2.2 times the federal baseline. While commercial insurance contracts typically range from 200% to 300% of Medicare rates, patients should verify their specific plan's negotiated amount, as some in-network rates may exceed the cash price. For individuals with high-deductible plans, paying the cash price directly can sometimes be more cost-effective than relying on insurance, provided the insurer's allowed amount is higher than $815.00.
The facility offers a median negotiated rate of $40.00, which is substantially lower than the cash price but may still result in out-of-pocket costs if the patient has not yet met their deductible. Patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront. Additionally, since over 80% of hospital bills contain errors, consumers should request a detailed, itemized statement before making any payments to ensure no duplicate charges or unbundled codes are included. Always confirm your deductible status and coverage limits with your insurance provider before scheduling to avoid unexpected financial responsibility.